Senior Customer Service Representative - National Remote

UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR, what you do matters. It's that simple . . . and it's that rewarding.

In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.

Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career.

In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our providers, helping answer questions and resolve issues regarding health care eligibility, claims and payments. You may be asked to review and research incoming healthcare claims from providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms to provide updates.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 5 weeks of paid training starting 7/14/2025. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday. Training will be conducted virtually from your home.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e., benefit, eligibility, authorizations for treatment, and claims
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Own problem through to resolution on behalf of the caller in real time or through comprehensive and timely follow-up with the provider
• Review and research incoming healthcare claims from providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms to provide updates to providers
• documents/certificates)
• Communicate and collaborate with providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, customer satisfaction and attendance
• This position will receive and handle both mostly provider calls: 50-60 daily.
• Provider calls including UHN and non UHN networks (custom provider network questions from UMR medical provider customers such as hospital/clinic)
• Handles unique customized employer benefit plans

UMR as a TPA Supports:

• Customers - are employers who use UMR as a TPA to administer their plans
• Providers - are medical providers (hospital/clinic)
• Members - are subscribers and dependents of self-insured employer plans
• Brokers - are consultants that work with the employer who might call UMR's service team on a question/claim; calls from Brokers are nominal as they normally reach out directly to the Sales Account teams or the Service Account Management team

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of customer service experience analyzing and solving customer's concerns
• This position will receive provider calls up to 50-60 calls daily and requires full attention to work duties. Employees in this role must be able to ensure they will have uninterrupted work time while they are on shift (outside of normally scheduled breaks and lunch)
• Ability to successfully complete the Customer Service training class and demonstrate proficiency of the material. The training class is 5 weeks of paid training starting 7/14/2025. The hours during training will be 8:00am to 4:30pm CST
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm CST. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• 2+ years customer service OR experience in the healthcare industry

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the provider
• Proficient problem-solving approach to quickly assess current state and formulate recommendations
• Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of customer communication styles and personalities
• Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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